Implicit Bias: When the Unconscious Creeps into Relationships - - PowerPoint PPT Presentation

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Implicit Bias: When the Unconscious Creeps into Relationships - - PowerPoint PPT Presentation

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Implicit Bias: When the Unconscious Creeps into Relationships Sherri L. Alderman, MD, MPH, IMH-E Mentor Clinical & Policy, FAAP Maternal, Infant, and Early Childhood Home Visiting Training Eugene, Oregon January 25, 2018 Disclaimer

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Implicit Bias: When the Unconscious Creeps into Relationships

Sherri L. Alderman, MD, MPH, IMH-E Mentor Clinical & Policy, FAAP Maternal, Infant, and Early Childhood Home Visiting Training Eugene, Oregon January 25, 2018

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Disclaimer

  • Neither I nor my immediate family have any financial

interests to disclose.

  • I do not intend to discuss any unapproved or

investigative use of commerical products or devices.

  • Reasonable attempts have been made to provide

accurate and complete information.

  • The practitioner or provider is responsible for use of

this educational material; any information provided should not be a substitution for the professional judgement of the practitioner or provider.

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Agenda

**Reflection Activity

  • 1. Introduction to Implicit Bias
  • 2. Pervasiveness of Implicit Bias
  • 3. Implicit Memory: The Sister of Implicit

Bias

  • 4. Conceptual Framework of Implicit Bias
  • 5. Bringing It Back to the Baby
  • 6. What We Can Do and Why

**Action Plan

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Goals & Objectives

  • 1. Define implicit bias
  • 2. Explore how implicit bias impacts

relationships

  • 3. Identify action steps that build capacity

to consider the role implicit biases may have in our work

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Oregon Home Visiting Core Competencies

  • 1. Professional Best Practice
  • 2. Professional Well Being
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Infant Mental Health Endoresment Core Competencies

  • 1. Reflection
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Reflection Activity

Think back—What is your earliest memory? What do you think makes it so memorable?

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Implicit biases are fascinating because they produce behavior that diverges from someone’s endorsed principles and beliefs.

Professor Phil Stinson

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1.

Introduction to Implicit Memory

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Implicit Bias

▷ Implicit bias = unconscious bias = implicit social cognition ▷ Attitudes or stereotypes that affect our understanding, actions, and decisions in an unconscious manner ▷ Develop over the course of a lifetime beginning at a very early age through exposure to direct and indirect messages ▷ Both favorable and unfavorable ▷ Activated involuntarily and without an individual’s awareness or intentional control ▷ Race, ethnicity, age, appearance

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Implicit Bias

▷ Do not necessarily align with our declared beliefs ▷ Pervasive ▷ Highly favor our own “in group” ▷ Malleable

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Explicit Bias

▷ Attitudes and beliefs we have about a person or group on a conscious level ▷ Drawing group boundaries (“in group”) that distinguish

  • neself from others (“out group”)
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Only 2% of emotional cognition is available consciously.

Emotional Cognition

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2.

Pervasiveness of Implicit Bias

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Research about implicit bias helps us to better understand the disconnect between our society’s ideal of fairness for all people and continued reality of its absence.

Professor John A. Powell

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Pervasiveness of Implicit Bias

▷ Employment ▷ Housing ▷ Criminal Justice ▷ Law Enforcement ▷ Education ▷ Media (subliminal messaging & microaggressions) ▷ Access to Public Services ▷ Health and Health Care

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Racial Discrimination in Local Public Services

▷ Email inquiries for information ▷ School districts, libraries, sheriff offices, treasurer offices, job centers, and county clerks ▷ Implied race (White or Black) conveyed by sender name ▷ Controlled for SES (by mention of occupancy in email) ▷ n = 19, 079 nationwide ▷ (nearly half of all potential recipients)

Guilietti, et al. 2015

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Implicit Bias

Location of Email Recipients, n=19,079

Guilietti, et al. 2015

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Guilietti, et al. 2015

Email Recipients Percentages By Provider Type

School Districts (52%) Libraries (26%) Sheriff Offices (10%) Other (Treasurers, Job Centers, County Clerks) (10%)

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Racial Discrimination in Local Public Services--FINDINGS

▷ Response rate overall ▷ 72% (of White senders’ emails), 68% ( of Black senders’ emails) ▷ Highly statistically significant ▷ Racial differences greater in rural areas (vs. urban) ▷ The higher the probability of the recipient being Black, the higher the probability of responding to a Black email

Guilietti, et al. 2015

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Black/White Gap in Response Rate vs. Black Share of Employed

Guilietti, et al. 2015

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Racial Discrimination in Local Public Services--Discussion

▷ Access to information is empowering ▷ Racial discrimination is illegal for agencies receiving federal monies ▷ Implicit bias likely contributes to behavior that is discriminatory against some groups

Guilietti, et al. 2015

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Implicit Association Test (IAT)

▷ Timed cognitive test used to measure the relative strength between positive and negative associations toward one social group compared to another ▷ Project Implicit: Implicit Association Test (IAT) ▷ https://implicit.harvard.edu/implicit/takeatest.html ▷ Test categories include disability, age, race, skin tone, weight, religion, sexuality, gender-career, gender-science,

  • thers

▷ WARNING: tests carry possibility for harm, confusion, and/or triggered emotions

Sabin and Greenwald 2012

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Implicit Bias in Health and Health Care

▷ MDs, on average, show pro-White implicit bias compared to AA and contrary to explicit bias self-reporting1 ▷ AA MDs, on average, did not show implicit bias for either Whites or Blacks1 ▷ Women showed less race implicit bias than men1 ▷ Greater implicit pro-White bias associated with prescribing narcotics for postsurgical pain for Whites and not AA2 ▷ MD pro-White race implicit bias associated with greater clinician verbal dominance toward AA patients, lower AA patient positive affect, and poorer patient ratings of MD on interpersonal care3

1Sabin, et al. 2009 2Sabin and Greenwald 2012 3Cooper, et al. 2012

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Until we deeply examine and challenge how racism and implicit bias affect our clinical practice, we will continue to contribute to health inequality.

Katherine C. Brooks (paraphrased)

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3.

Implicit Memory: The Sister of Implicit Bias

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Implicit Memory

▷ Emotional sensory memories ▷ Unconscious ▷ Negative and positive emotional experiences

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Implicit Memory

▷ Cortisol impedes explicit memory processing ▷ Catecholamines (adrenaline) increase implicit encoding of fear and enhance implicit memory processing

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Implicit Memory

▷ Right-left brain integration can play a role in reducing unconscious behavioral responses ▷ Reflective process can be a mechanism for building right-left brain integration

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4.

Conceptual Framework of Implicit Bias

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We live with this inherent dichotomy between the rational decisions we think we are supposed to be making and the real impact of

  • ur unconscious processing.

Howard Ross

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Brain Regions Associated with Race Implicit Bias

Kubota et al. 2012 Executive function control Activated when conflict between automatic implicit bias and egalitarian beliefs Fear

* * *ingroup/outgroup modulated

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In Group vs. Out Group

▷ Individuals perceived as belonging to our own social group vs. ▷ Individuals perceived as belonging to social groups other than our own

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Fear Learning

▷ Amygdala, anterior insula, and anterior cingulate cortex are key contributors to differentiating between White and Black faces ▷ Conditioned fear response toward racial outgroup members is more generalized to all members ▷ Conditioned fear response toward racial outgroup members persists longer compared to ingroup ▷ Study restricted to White participants (and White and Black visuals)

Molapour TG, et al. 2015

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Cognitive Depletion

▷ Interracial communication may be taxing and adversely impact cognitive function

Zabel, et al. 2015

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Racial Anxiety

▷ Discomfort about the experience and potential consequences of interracial interaction ▷ Inhibit individuals from pursuing intergroup relationships ▷ Cause tension during a cross-race interaction ▷ Increase likelihood that interaction will unfold in a non- productive way ▷ Knowledge of implicit bias may exacerbate racial anxiety

National Public Radio 2015

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Visuo-Motor Interference

▷ Perceived ingroup vs. outgroup status impacts a person’s ability to predict other’s movements and adapt to them ▷ Unconscious mimicry of others’ postures and mannerisms during interactions may have the social scope of promoting affiliation ▷ Voluntary mimicry of outgroup members may reduce racial bias

Sacheli, et al. 2015 Bortoletto, et al. 2013

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Entitativity

▷ Groups that are cohesive, similar, and share a common fate ▷ Perceptions of race intitativity are associated with a greater tendency to give explicit voice to their implicit prejudice against another race

Effron and Knowles 2015

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Obama Effect

▷ Extensive exposure to a prominent figure contradicting stereotypic prejudices can decrease implicit bias

Plant, et al. 2009

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5.

Bringing It Back to the Baby

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It may not have been your intention when you were crossing the road for you to step on my foot, but the impact of you stepping on my foot, it still remains.

Anonymous

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Infant Own- vs. Other-Race Preference

▷ Infants see more human, female, and own-race faces ▷ Exposure impacts development of face processing skill ▷ Limited spectrum of exposure to face types relates to poorer face processing abilities

Liu et al. 2015

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Infant Own- vs. Other-Race Preference

▷ 3-month old infants are able to recognize and discriminate between both other-race and own-race faces ▷ By 9 months, infants lose ability to discriminate and recognize other-race faces ▷ “perceptual narrowing”

Liu et al. 2015

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Infant Own- vs. Other-Race Preference: Familiarity-to-Novelty Shift

▷ Visual experiences affect face processing in the first few months after birth ▷ Newborns do not display any preferences ▷ By 3 months, infants show preference for own-race faces ▷ By 9 months, infants show preference for other-race faces

Liu et al. 2015

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Infant Own- vs. Other-Race Preference: Facial Scanning Patterns

▷ Research suggests that infants may use a more advanced strategy for scanning own-race faces (?based on greater experience?) ▷ Infants by 9 months show predilection for or avoidance of eye contact consistent with cultural norms

Liu et al. 2015

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Ethnic-Racial Socialization and Implicit Bias

▷ Socialization involves explicit and implicit verbal and nonverbal messaging ▷ Exposure to objects, experiences and contexts ▷ Modeling behaviors ▷ Affective responses ▷ Mechanism includes not just message content but also mode of transmission

Yasui 2015

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Ethnic-Racial Socialization and Implicit Bias

▷ Mother’s implicit biases (not explicit) predict 3-6 yo children’s racial attitudes1 ▷ Explicit teaching of family culture, beliefs, and attitudes are accompanied by spontaneous/automatic verbal, affective, and behavioral responses ▷ Conveyed explicit and implicit information may be different ▷ Will determine what the child learns2 ▷ More research needed, especially on process of transmission

1Castelli, et al. 2009 2Yasui 2015

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Media, Microaggressions, and Implicit Bias

▷ Media present explicit visuals with often strong emotional content ▷ Repeated messaging and profiling instills and reinforces stereotypes ▷ Media as a conduit of implicit racial attitudes transmission into the home ▷ Media can also be a window out into the world of diversity ▷ How messages are framed, worded, and illustrated determine what is communicated

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We essentially ‘catch’ racial bias from others by merely observing subtle nonverbal cues.

Castelli, et al.

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6.

What We Can Do and Why

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Past events lay down traces that can resurface in the present. Reflective supervisors acknowledge this by wondering about the ways past events may have shaped a family’s behavior, feelings, or choices.

Mary Claire Heffron

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Why Do Anything?

▷ Implicit biases are a universal human characteristic ▷ Implicit bias is malleable ▷ Taking ownership of our implicit attitudes influences begins the process of integration between our right brain (implicit biases) and our left brain (explicit biases)

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Why Do Anything?

▷ Awareness of our inherent potential for implicit biases sets into motion a process that can lead to cognitive control of

  • ur unconsciously motivated behaviors

▷ Increased awareness of implicit biases is the key to congruent unification of one’s beliefs and behavior ▷ We have a professional, ethical, and moral responsibility to reflect on our behaviors and be curious about their origins

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Why Do Anything?

▷ Practicing a reflective process with own implicit biases builds experience applicable to developing a deeper understanding of the complexity of challenges that our clients face

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What We Can Do

▷ Seek Educate & Increase Self-Awareness Trainings such as this Take the Implicit Association Test (IAT) at implicit.harvard.edu ▷ Take Action Seek out positive intergroup interactions Promote diversity in the workplace Take perspective-taking in your work with clients to a new level by including consideration of implicit biases that may be playing a role in clients’ challenges ▷ Be Accountable Take ownership of your own implicit biases Be curious and willing to explore the potential of implicit biases during your RS sessions

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Summary

  • 1. Implicit bias is a universal human

characteristic.

  • 2. Implicit biases are laid down very early

in brain development.

  • 3. Implicit biases are malleable.
  • 4. Intentionally considering implicit

biases can enhance and enrich our work.

  • 5. Reflective supervision is a venue

amenable to processing implicit biases

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Action Plan

Write down where you are on a scale of 1-10 regarding your awareness of implicit bias with 1 being new to the concept and 10 being an expert. Write down what step you are ready to take that will move you up on the scale.

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Thank you!

Questions: sherri.alderman23@gmail.com

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References

Bortoletto M, Mattingley JB, Cunnington R (2013). Effects of context on visuomotor interference depends on the perspective of observed actions, PLOS One 8(1):e53248. doi:10.1371/journal.pone.0053248. Castelli L, Zogmaister C, Tomelleri S (2009). The transmission of racial attitudes within the family, Developmental Psychology 45(2):586-591. Cooper, LA, Roter, DL, Carson, KA, et al. (2012). The associations of clinicians’ implicit attitudes about race with medical visit communication and patient reatings of interpersonal care, American Journal of Public Health, 102(5):979- 988. Effron DA, Knowles ED (2015). Entitativity and intergroup bias: How belonging to a cohesive group allows people to express their prejudices, Journal of Personality and Social Psychology 108(2):234-253.

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References

Guilietti, C, Tonin, M, Vlassopoulos, M (2015). Racial discrimination in local public services: A field experiement in the US, Institute for the Study of Labor, Accessed from http://ftp.iza.org/dp9290.pdf, Retrieved January 14, 2018. Kubota JT, Banaji MR, Phelps EA (2012). The nueroscience of race, Nature Neuroscience, 15(7):940-948. Liu S, Quinn PC, Chen H, Pascalis O, et al. (2015). Development of visual preference for own- versus other-race faces in infancy, Developmental Psychology, 51(4):500-511. National Public Radio (2015). How do we improve dialogue about race relations: An interview with Linda Tropp, Retrieved at https://www.umass.edu/peacepsychology/linda-tropp-was-interviewed- regarding-racial-tensions-and-perceptions-pbs-new-hour, Accessed January 16, 2018.

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References

Plant AE, Devine PG, Cox WTL, et al. (2009). The Obama effect: Decreasing implicit prejudice and stereotyping, Journal of Experimental Social Psychology, 45(4):961-964, Sabin AS, Greenwald AG, (2012). The influence of implicit bias on treatment recommendations for 4 common pediatric conditions: Pain, urinary tract infections, attention deficit hyperactivity disorder, and asthma, American Journal of Public Health, 102(5):988-995. Yasui M (2015). A review of the empirical assessment of processes I ethnic- racial socialization: Examining methodological advances and future areas of development, Developmental Review, 37(1):1-40. Zabel KL, Olson, MA, Johnson CS, Phillips JE (2015). What we talk about matters: Content moderates cognitive depletion in interracial interactions, The Journal of Social Psychology, 155(6):545-552.